| 수술 후 기억력 예후 판단에 있어서의 4가지 Wada 기억력 비대칭지수의 예측도에 대한 평가 |
| 이향운, 홍승봉, 김경원*, 한승혜, 서대원, 이원용, 김병준, 정진상, 홍승철# |
| 성균관대학교 의과대학, 삼성서울병원 신경과, 신경외과#, 마산의료원 신경과* |
| Predictive Values of Four Wada Memory Asymmetry Indices in Postsurgical Memory Outcome |
| Hyang Woon Lee, M.D., Seung Bong Hong, M.D., Kyung Won Kim, M.D.*,
Seung Hye Han, M.D., Dae Won Seo, M.D., Won Yong Lee, M.D.,
Byoung Joon Kim, M.D., Chin Sang Chung, M.D., Seung Chyul Hong, M.D#. |
| Epilepsy Center, Departments of Neurology and Neurosurgery#, Samsung Medical Center, College of Medicine, Sungkyunkwan University, |
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| Abstract |
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Background : The interpretation of Wada memory test is various in different epilepsy centers. Four types of Wada memory score (WMS) were defined by four different criteria to determine the best WMS in predicting postsurgical memory outcome. Methods : Twenty temporal lobe epilepsy patients underwent Wada test before surgery and pre- and post-operative neuropsychological tests. WMS was obtained by four ways; including 1) total stimulating items, 2) items presented between one and two minutes after amobarbital injection, 3) items presented before ipsilateral EEG slowing decreased to 50%, 4) items presented until EEG slowing disappeared. Wada memory asymmetry index (WAI) was determined by [(WMS of normal side ? WMS of epileptic side)/their mean]. Logical and visual memory tests were performed before and after operation. Neuropsychological asymmetry index (NPAI) was defined as [(postsurgical score ? Presurgical score)/their mean]. Spearman correlation coefficients were obtained between WAIs and NPAIs. Results : WAIs obtained by method 2) and 3) showed relatively good correlation with NPAIs. Visual memory outcome was correlated with WMS better than logical memory both in non-dominant and dominant hemisphere epilepsy groups. The lateralizing value of memory dominance in non-dominant hemisphere epilepsy group was greater than that of dominant group. Conclusions : Early presented stimuli during Wada test had a better predictive value of postoperative memory outcome.
Key Words : Wada test, Wada memory asymmetry index , Neuropsychological test, Temporal lobe epilepsy |
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